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[中风后抑郁:识别与治疗干预]

[Post-stroke depression: recognition and treatment interventions].

作者信息

Arseniou S, Arvaniti A, Samakouri M

机构信息

Department of Psychiatry, Democritus University of Thrace, Alexandroupolis, Greece.

出版信息

Psychiatriki. 2011 Jul-Sep;22(3):240-8.

Abstract

Depression is the most common neuropsychiatric complication of a stroke (Post Stroke DepressionPSD) and has been shown to impede the recovery and rehabilitation of these patients. Prevalence rates of PSD vary between 6% and 79%. Direct comparison between studies is limited due to their different methodology. Etiology of PSD is determined by biological and psychosocial factors. Symptoms of PSD appear in three areas: affective, somatic and cognitive. Differential diagnosis includes post-stroke fatigue and pseudo-depressive manifestations of ischemic infarctions (apathy, aprosody, athymhormia, pseudobulbar palsy). Mortality in post-stroke patients is higher than in non-depressed stroke patients and suicide ideation is observed in 6.6-11.3% of stroke patients. Selective serotonin reuptake inhibitors (SSRI) are considered as the first choice treatment of PSD. Other therapeutic approaches include cognitive and functional rehabilitation. PSD is a potentially treatable condition, yet under-diagnosed, and has a negative effect on functional recovery and survival of stroke patients.

摘要

抑郁症是中风最常见的神经精神并发症(中风后抑郁症,PSD),已被证明会阻碍这些患者的康复。PSD的患病率在6%至79%之间。由于研究方法不同,各研究之间的直接比较受到限制。PSD的病因由生物学和心理社会因素决定。PSD的症状出现在三个方面:情感、躯体和认知。鉴别诊断包括中风后疲劳和缺血性梗死的假性抑郁表现(冷漠、失韵律、情感淡漠、假性球麻痹)。中风后患者的死亡率高于非抑郁性中风患者,6.6-11.3%的中风患者存在自杀意念。选择性5-羟色胺再摄取抑制剂(SSRI)被认为是PSD的首选治疗方法。其他治疗方法包括认知和功能康复。PSD是一种潜在可治疗的疾病,但诊断不足,对中风患者的功能恢复和生存有负面影响。

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